Vecuronium Bromide for Injection Rx
Generic Name and Formulations:
Vecuronium bromide 10mg/10mL; pwd for IV inj after reconstitution; contains benzyl alcohol, mannitol.
Various generic manufacturers
Indications for Vecuronium Bromide for Injection:
Adjunct to general anesthesia to facilitate endotracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation.
Adults and Children:
<7wks: not recommended. Individualize. >7wks–10yrs: see literature. ≥10yrs: Relaxation for intubation: inject bolus dose of 0.08–0.1mg/kg; may reduce dose to 0.06–0.085mg/kg if given >5 minutes after start of inhalation agent or when steady state has been achieved. Give 1microgram/kg/min (range: 0.8–1.2microgram/kg/min) by continuous IV infusion 20–40 minutes after initial dose. Inhalation anesthetics (eg, enflurane, isoflurane): reduce infusion rate 25–60%, 45–60 minutes after initial dose. Intubation with succinylcholine: reduce initial vecuronium dose to 0.04–0.06mg/kg with inhalation anesthesia; and to 0.05–0.06mg/kg with balanced anesthesia. Prolonged surgery: maintenance dose of 0.01–0.015mg/kg, within 25–40 minutes of initial dose. During surgery under halothane anesthesia: initial dosing range from 0.15mg/kg up to 0.28mg/kg have been given. Monitor with a peripheral nerve stimulator to avoid overdosage.
To be administered under the supervision of experienced clinicians. Have intubation, artificial respiration, oxygen therapy and reversal agents available. Myasthenia gravis or myasthenic (Eaton-Lambert) syndrome (do test dose and monitor). Renal failure. Hepatic impairment. Cardiovascular disease and edematous state. Long-term use in I.C.U. Immobilized for long periods. Severe obesity or neuromuscular disease; monitor airway and ventilation. Electrolyte imbalance. Adrenal cortical insufficiency. Malignant hyperthermia. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat.C). Nursing mothers.
Prior administration of succinylcholine may potentiate effects (delay vecuronium dose). Potentiated by volatile inhalational anesthetics (eg, enflurane, isoflurane, halothane), aminoglycosides, tetracyclines, bacitracin, polymyxin B, colistin, sodium colistimethate, magnesium salts. Additive effects with pancuronium, d-tubocurarine, metocurine, and gallamine. Caution with quinidine injection.
Neuromuscular blocker (nondepolarizing).
Skeletal muscle weakness or prolonged paralysis, muscle atrophy, respiration insufficiency, apnea; rare: hypersensitivity reactions.
Formerly known under the brand name Norcuron.